Heart disease patients with positive attitudes are more likely to exercise and live longer, according to new research in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Researchers used a questionnaire to assess the moods of 600 ischemic heart disease patients in a Denmark hospital. Five years later, researchers found:

The most positive patients exercised more and had a 42 percent less chance of dying for any reason during the follow-up period; deaths were less than 10 percent.

Positive mood and exercise also cut the risk of heart-related hospitalizations.

Ischemic heart disease, also called coronary artery disease, is caused by narrowed arteries that don't provide enough blood and oxygen to the heart.

Exercise levels the playing field between positive and negative patients, researchers said. So the differences in death rates between upbeat and sad heart patients weren't as striking when both groups exercised. However, information on the types and amounts of exercise were not available.

Other studies have shown that heart patients' optimistic mood improves their health.

"We should focus not only on increasing positive attitude in cardiac rehabilitation, but also make sure that patients perform exercise on a regular basis, as exercise is associated with both increased levels of optimism and better health," said Susanne S. Pedersen, Ph.D., one of the study authors and professor of cardiac psychology, the Department of Medical and Clinical Psychology, Tilburg University, the Netherlands, and adjunct professor of cardiac psychology, the University of Southern Denmark and Odense University Hospital, Denmark.

Mood and exercise have a chicken-and-egg, two-way relationship with each factor influencing the other, she said.

The study's results on patients, predominantly white and 75 percent male, likely apply to a wider range of cardiac patients, including those in the United States, Pedersen said.

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